Apply for Student Clinical Application

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Student Clinical Application
ID:1111
Location:***
Department:99-Student
Status:Temporary
Resume
Resume:
Supported formats: Word, PDF, RTF, Text, and HTML.
  - or Upload from:
 
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Application Information
* Pay Type:
Attachments
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Student Questions
* Permanent Address:
* Permanent Address 2:
* Permanent City, State, ZIP:
* School Affiliation:
* Student Program of Study:
Physical Therapy
Occupational Therapy
Speech Therapy
Athletic Training
Physical Therapist Assistant
Occupational Therapy Assistant
Other
If Other, please list:
* Current Level of Education:
* Anticipated Date of Graduation:
* Encore Clinical Location (City Name):
* Date of Clinical:


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